Loading...
HomeMy WebLinkAboutDrain Layers Permit 80 High Street T OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL � • � B/P No.: South Windsor, Connecticut List No.: _ DRAIN LAYER'S PERMIT © 1187 � r � 219 Pursuant to written applic for pe{mission is h reb ants the Licensed Drain Layer named herein to perform th ork i icated below at ' ' OfTJ on the side, between !I ' at premises owned b , whose address is and to Lay House Drain, Repair House Drain, Lay-Main, Other for occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE O, INDUSTRIAL WASTES (. ), OR ( ) Connection will be made with r Permit to,be issued to the holder of Drain Layer's License No. . 0 J� ,2 7 Permit will expire on `�' �/ 19 y Tl a undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the feverse side thereof. Applicant has received Town Permit No. and/or C H D Permit No. for street excavation. SPECIAL CONDITIONS Signed Connection Charge Paid Licensed Drain Layer Issued by ;•: j Tax Collector Permit Fee: Paid $ INSPECTION: Check Number: INITIAL (Sig) FINAL (Sig) APPROVED 17/]J (Date) (Sig) - INSPECTOR